Provider Demographics
NPI:1811106925
Name:SERENITY SENIOR CARE
Entity type:Organization
Organization Name:SERENITY SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:INCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-338-0124
Mailing Address - Street 1:2 BROAD ST STE 208
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2548
Mailing Address - Country:US
Mailing Address - Phone:973-338-0124
Mailing Address - Fax:973-338-0080
Practice Address - Street 1:20 STONE ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4034
Practice Address - Country:US
Practice Address - Phone:973-338-0124
Practice Address - Fax:973-338-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health